T2 - Eye Flashcards
What does 20/15 vision mean?
20/200?
The person can see at 20 feet what the normal person can see at 15 feet (better than normal vision).
The person can see at 20 feet what the normal person can see at 200 feet (horrible vision)
When should you get vision screening exams?
Every 1-2 years normally, but more frequently in patients with DM, glaucoma.
The optic disc should have a ______ outline. The cup (smaller circle) disc (larger circle) ratio should be?
Sharp.
<0.5 or < 5/10
In a fundoscopic exam, the arteries are _____ than veins and the veins ______
Narrower
Pulsate.
Reasons NOT to dilate?
Globe rupture, head injury, narrow angle glaucoma.
If you see AV nicking what should you think?
HTN. Considered mild retinopathy.
If you see cotton wool spots what should you think?
HTN, DM - micro-infarcts. Moderate retinopathy.
If you see flame hemorrhages, what should you think?
HTN, DM - micro-infarct. Blot and dot, hard exudates, micro-aneurysms. Moderate retinopathy.
What is a scotoma?
A central blind spot that can indicate macular degeneration.
If your patient is seeing a curving of straight lines but their peripheral and color vision are normal, what do you suspect?
Macular degeneration.
Increased risk of cataracts with
DM, Steroid use, injury to eye.
Glaucoma will see an increased cup/disc ration of ______ and an increase IOP ______
> 0.5
21mmHg
Is closed or open angle glaucoma an emergency?
Closed. Pupil will not dilate. Painful.
Tx for acute close angle glaucoma
BB drops (timolol)
Apraclonidine (alpha-adrenergic agonist)
Pilocarpine (parasympathomimetic miotic agent)
Mannitol in extreme situations.
Your patient has a unilateral acute reduction in vision. It is painful especially with eye movement. Their visual acuity is affected AND their color vision is also effected. What do you suspect? Causes? Tx?
Optic Neuritis.
Causes: MS, childhood vaccines, infections, SLE, inflammation
Tx: consult and referral to ophthalmology
Your patient has a sudden painless monocular vision disruption with a less transparent, pale, edematous retina. There is a cherry spot noted on fundoscopic exam. What do you suspect?
Central retinal artery occlusion. Immediate referral!
Your patient had a flash of light and some floaters. Then decreased central and peripheral vision in the L eye with no pain. What do you suspect?
Retinal detachment.
Your patient has bilateral blurred disc margins with diminished cup ratio and some hemorrhages. They have a decrease in visual acuity with N/V and HA. What do you suspect?
Papilledema - bilateral edema at head of optic nerve from ICP - refer MRI CT, LP!!
Tx for Preseptal or periorbital cellulitis
Augmentin or 1st gen cephalosporins. close f/u 24-48hrs.
Tx for postseptal - orbital cellulitis?
Broad spectrum abx inpatient tx.
Difference between a stye (hordeolum) and chalazion
Chalazion - LARGE oil gland blockage
Hordeolum - smaller follicle and sweat gland blockage.
Blephritis is overgrowth of _______ bacteria
S. Epidermitis.
Tx for bacterial conjunctivitis:
Contact lense wearers?
Trimethoprim-polymixin
Erythromycin
FQ or aminoglycosides.
your patient has hermetic dendrites visible on flouresceine stain. What should you do?
Refer to Ophthalmology immediately. Cold compress, ocular decongestant, artificial tears, HIGHLY contagious.
Which type of conjunctivitis has cobblestoning?
Viral
T/F: you should prescribe ocular steroids with ocular infections.
False. May worsen the infx.
What is the difference between a pinguecula and a pterygium?
Pinguecula= yellow spot, elevated, near corona, can cause FB sensation and chronic redness. Short course steroids 4-7days and refer.
Pterygium= benign growth of conjunctiva from nasal side due to UV light exposure.
